The invention relates to electromechanical devices adapted to be worn by children with Autistic Spectrum Disorder to be used in behavioral and educational settings. The term xe2x80x9cSpectrum Disorderxe2x80x9d refers to a related group of disabilities including autism, Asperger""s Disorder and Persuasive Development Delay/Not Otherwise Specified (PDD-NOS), Rett""s Disorder and Childhood Disintegrative Disorder. The device permits a teacher or therapist to activate a tactile stimulus to evoke a desired behavior.
Wristwatches and other devices with silent tactile alarm systems have been described for a variety of applications. They have been developed as signaling devices for the deaf and hearing impaired. Similarly, they may find useful applications in environments with high noise levels or in situations, such as a meeting, a concert where an audible signal would either be undesirable or disruptive. Devices with tactile stimulation also have proven useful tools for teaching children with behavioral and learning impairments. These devices are easily concealed to avoid social stigma, only the individual wearing the device is aware of the signal which avoids disruption in a classroom environment and the devices can be programmed to adapt them to a variety of situations.
A watch with a tactile alarm and an electronic message display system developed primarily for adolescents with Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) has been described in U.S. Pat. No. 5,861,797. This device can be programmed to produce a tactile signal to alert the wearer that a preprogrammed message is being displayed on an output device. The message is a programmed reminder to initiate some predetermined behavior, e.g. take medication, or it can be programmed to be activated at fixed intervals to attempt to refocus behavior. These devices help enable an individual with ADHD to achieve higher levels of independence and maintain more normal performance levels in school.
Common behavioral disorders and learning disabilities differ widely in their severity, symptoms and available treatment modalities. The device described in U.S. Pat. No. 5,861,797 meets the specific needs of ADD and ADHD patients; however many conditions are more profound and combine learning and behavioral impairment. Autism and Asperger""s Disorder are two examples that require much more individualized and intensive training methods and there is an unfilled and urgent need for new and improved techniques to train children with Autistic Spectrum Disorder to be as fully functional and independent as possible.
Autism is a syndrome with a broad spectrum of behavioral, sensory integration, and learning difficulties whose severity can range from mild to profound. Autistic children cannot bring new stimuli into a meaningful relationship with past experience. Auditory and visual messages give particular difficulty and as a consequence speech is not acquired or develops late in dysphasic form. The senses for touch and taste, and smell are preferred. The use of a tactile signal, therefore, might avoid some of the difficulties processing auditory signals and relies on touch or tactile stimulation which is more readily accommodated. The capacity for contact fails to develop normally and proximity to human beings is avoided and the autistic child can be severely withdrawn. This may result from the intolerable complexity of the visual and auditory stimuli emitted by a moving speaking individual. Children with autism have a strong tendency to maintain uniformity in the environment, and any attempt to interrupt a child in the course of a task may evoke anxiety and rage. Asperger""s Syndrome is a diagnosis applied to children who have good language and cognitive skills but exhibit the social, emotional, behavioral impairments which occur in autistic children.
The severity and clinical manifestations of these conditions vary widely; however, with proper support and training, many patients suffering from autism and related disorders can learn to function more independently. Although the child frequently cannot communicate with others, he may have an outstanding ability for rote learning. Although training and education adapted from operant conditioning have achieved some measure of success, this has not lessened the need for new techniques to improve instruction and training and children with behavioral and learning disorders.
This invention has several aspects that are intended to enhance its value in treating and training children who exhibit the spectrum of learning and behavioral disabilities typically diagnosed as autism or Asperger""s Disorder. The present device comprises a tactile stimulatory device which can be activated by remote control by a teacher or therapist attempting to teach a particular behavioral pattern. Activation of the device, therefore, provides a tactile cue to prompt a particular behavior pattern.
Because the patient may have altered sensitivity to tactile stimulation another aspect of the present device is an adjustable mechanism which permits the teacher, therapist or caregiver to adapt the intensity and characteristics of the response for a particular individual or situation. An individual may require a relatively high level of stimulation to recognize a behavioral cue whereas another individual may be unable to tolerate that stimulus. During the course of behavior training it may be frequently desirable to decrease the intensity of the stimulation in a stepwise manner as the patient becomes more proficient at exhibiting the desired behavioral pattern and ultimately to eliminate the stimulus when the behavioral pattern has been learned.
In addition to the remote activation of a tactile signal the present invention can also comprise an alarm that can be programmed to automatically activate at a particular time or to be activated at a regularly programmed interval. This has previously been described in devices for training ADD and ADHD patients. Since this aspect is distinct from the remote stimulation, the signal from the remote cue should be different and distinguishable from a programmed signal.
While teaching individuals with Autistic Spectrum Disorder is a particular application of the present device, the invention should not be construed to be in any way limited to this use. Tactile alarms have been adapted for a variety of situations where auditory or visual cues would be undesirable. Thus the technique can be used to produce a signal in meetings or gatherings where a visual alarm would be undesirable and disruptive. They also can be used in noisy environments where an audible signal may not be noticed. A combat situation or police operation represents still another situation where a normal alarm could be undesirable.
In a preferred embodiment of this invention a battery powered digital alarm wristwatch is combined with a electromechanical motor, suitable driven components and a receiving unit so that at preset times or when the receiving unit is activated by an external signal the motor induces a vibration which will signal the wearer.